The prevalence of problem-drinking and other health-related behaviours in a sample of Hong Kong general hospital patients

Author name used in this publication: David ArthurAuthor name used in this publication: Leung Sau FongVersion of RecordPublishe

The prevalence of problem drinking and other health-related behaviours in a sample of Hong Kong general hospital patients

Objective: Little research evidence is available on the prevalence of problem drinking and other health related behaviours in Hong Kong. The purpose of this study was to test the utility, the validity and reliability of the AUDIT, a well-tested and validated screening instrument for alcohol consumption, in the Chinese language and with a sample of Hong Kong hospital patients. The study examined the prevalence of problem-drinkers amongst a sample of general hospital patients and compared this to the prevalence of other health-related behaviours. Method: The AUDIT was translated into Chinese and embedded in a broader lifestyle questionnaire and administered to a convenience sample of 121 general hospital patients in a busy Hong Kong general hospital. Results: 44% of the sample had received no formal education or were educated at the primary level and the respondents felt the people who should be interested in their health were relatives and friends ahead of doctors and nurses. The sample expressed they had a definite weight problem (28%); an eating problem (16%); a smoking problem (22%); a drinking problem (4%) and a fitness problem (23%). The AUDIT proved internally consistent and was able to detect that 44% of the respondents were non-drinkers and that 11 % were drinking at a hazardous or harmful level. Conclusions: The findings encouraged the future use of this Chinese version of the AUDIT in future research and provided useful baseline data for health related behaviours as well as suggesting that Hong Kong health care workers consider seriously their role in working with people and their families in relation to health promotion and education

Determination of the tension softening curve of nuclear graphites using the incremental displacement collocation method

postprin

鑑古識今：從課程發展策略的視角看課程改革

This article, by analysing the Mathematics curriculum development of Hong Kong in the period 1940s-1980s, aimed to learn from the past. It stressed that the education bureau had adopted various effective strategies in curriculum development, though it centrally-controlled the development. The education bureau had adopted incremental model through consideration of context, implemented curriculum orderly and used techniques of absorptive politics to introduce strengths and ideas from grassroots and to interact with teacher associations. Inquiring from historical development, this article raised five dimensions of thought for curriculum development: strategies need to consider trends of recent change, considering the context of society, provision of space and flexibility when using top-down approach, accepting voice from grassroots, and investigating the possibility of devolution of power when responding to requests. 鑑古識今，本文從分析1940 - 1980期間香港小學數學課程的發展，指出香港過往的數學課程發展雖然由桝育 部門作「中央監控」，但亦採取「漸進發展」的課程發展模式，因應時勢，有序地推行數學課程改革，而且 以吸納政治的技巧，引入民間力量和聲音，著重與桝師團體的互動。從歷史發展的探索，本文提出五方面的 思考：課程發展策略要因應時勢發展，需因地制宜，雖由上而下但仍給予自主空間和彈性，容納民間聲音， 以及探討權力下放的可行性以回應時代需求

A systematic review of the effects of residency training on patient outcomes

<p>Abstract</p> <p>Background</p> <p>Residents are vital to the clinical workforce of today and tomorrow. Although in training to become specialists, they also provide much of the daily patient care. Residency training aims to prepare residents to provide a high quality of care. It is essential to assess the patient outcome aspects of residency training, to evaluate the effect or impact of global investments made in training programs. Therefore, we conducted a systematic review to evaluate the effects of relevant aspects of residency training on patient outcomes.</p> <p>Methods</p> <p>The literature was searched from December 2004 to February 2011 using MEDLINE, Cochrane, Embase and the Education Resources Information Center databases with terms related to residency training and (post) graduate medical education and patient outcomes, including mortality, morbidity, complications, length of stay and patient satisfaction. Included studies evaluated the impact of residency training on patient outcomes.</p> <p>Results</p> <p>Ninety-seven articles were included from 182 full-text articles of the initial 2,001 hits. All studies were of average or good quality and the majority had an observational study design.Ninety-six studies provided insight into the effect of 'the level of experience of residents' on patient outcomes during residency training. Within these studies, the start of the academic year was not without risk (five out of 19 studies), but individual progression of residents (seven studies) as well as progression through residency training (nine out of 10 studies) had a positive effect on patient outcomes. Compared with faculty, residents' care resulted mostly in similar patient outcomes when dedicated supervision and additional operation time were arranged for (34 out of 43 studies). After new, modified or improved training programs, patient outcomes remained unchanged or improved (16 out of 17 studies). Only one study focused on physicians' prior training site when assessing the quality of patient care. In this study, training programs were ranked by complication rates of their graduates, thus linking patient outcomes back to where physicians were trained.</p> <p>Conclusions</p> <p>The majority of studies included in this systematic review drew attention to the fact that patient care appears safe and of equal quality when delivered by residents. A minority of results pointed to some negative patient outcomes from the involvement of residents. Adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes. Limited evidence is available on the effect of residency training on later practice. Both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver high quality care.</p

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

從香港數學課程發展的歷史經驗透視當前課程發展與決策的幾個問題

The Proceedings Of The 10th Curriculum Studies Academic Conference For Mainland, Taiwan And Hong Kong: Curriculum Decision Making主題：課程決

Effectiveness of posture correction girdle as conservative treatment for adolescent idiopathic scoliosis : a preliminary study

202202 bcvcVersion of RecordOthersThis work is supported by funding from the Innovation and Technology Commission through an ITF public sector trial scheme [ITT/028/15GP] entitled ‘Development of Posture Correction Girdle for Adolescents with Early Scoliosis and the RGC General Research Fund [PolyU 152101/16E].Publishe